George structural collapse: Emergency Medical Service response - By Richard Botha

By Richard Botha, EMS-Rescue, Western Cape Government Department of Health and Wellness

Monday, 6 May 2024, was an unforgettable day for us in the Garden Route and Provincial EMS. Our service team embodies the motto: “A health-focused EMS system delivered by skilled, efficient and motivated personnel, equipped with the necessary resources that can be rapidly accessed and responds promptly to ensure patients receive appropriate care in the shortest possible time, leading to the best patient outcomes.”

At 14:14, our Garden Route EMS Call Centre received a call regarding a building collapse on Victoria Street, across from the George Municipality building, with reports of people trapped inside. All EMS units, including Ambulance, Rescue, Planned Patient Transport, and the Management Structure, were dispatched.

Upon arrival at the scene at 14h24, we assessed the situation and immediately implemented the Major Incident Medical Management and Support Plan (MIMMS). This plan is invoked when the number, severity or type of casualties or the location of the incident, requires extraordinary resources. We reported to Chief Fire Officer Neels Barnard, the incident commander of the George Fire Department, providing a scene report detailing the building collapse and the fact that workers were trapped under debris. Additionally, a methane report was relayed back to our call centre.

Major incident: Declared a major incident

Exact location: Incident on Victoria Street opposite the George Municipality building

Type of incident: Multiple-storey structural collapse

Hazards: Unstable structure, building material like scaffolding Access and egress route: From York Street into Victoria Street Number and severity of casualties: 70 plus trapped under the building material

Emergency Services: EMS –Ambulance and Rescue, Fire Service, Police, Traffic, additional resources were requested from District and Provincial The Control, Safety, Communication, Assessment, Triage Treatment, Transport (CSCATTT) principles were followed in conjunction with ICS Operational Section Chief layout.

Command “Bronze, Silver, Gold” and Control, Safety, Communication, Assessment, Triage Treatment, Transport

Our EMS Rescue Team, led by Richard Botha, collaborated with the multi-sectoral rescue teams, to facilitate the rescue of individuals trapped under the building structure. The highly trained and designated rescue technicians specialised in structural collapses worked seamlessly together, utilising all available rescue equipment from local, district and provincial levels at the scene.

Our medical teams ensured a high level of performance in triage, treatment and transportation, working alongside local and provincial medical doctors under the leadership of our Provincial Disaster Medicine Doctor, Dr Wayne Smith. In total, we rescued 14 patients classified as red, seven as yellow, seven as green and 34 as blue from the collapse site. The rescue operation was successfully concluded on 17 May 2024.

Lots of rescues was done and people lives were saved, but there is one rescue that was giving hope for more lives that might be saves. That was the rescue of Gabriel on day 6 when the K9 Search and rescue dogs, our EMS Search and Rescue Camera team gives us the positives that there is a patient that is still alive under collapse concrete floors. The rescue teams has started the drilling and breaking of the concrete finally a light in the end of darkness for Gabriel as he was medically stabilized and packaging for removal from the rubble by the rescue team for a full examination by our medical team and transportation with the ambulance to the hospital.

Successes

• Collaboration of the multidisciplinary rescue teams

• The success rate of medical and rescue staff in collaborating as a cohesive unit to save and transport lives

• The efficiency of rescue workers functioning inside a unified command structure/ system

• Positive and functioning command controlled system

• The success of the rescue operation and the survival rate

• Metro Rescue structural collapse training provided rescuers with a platform from which to work

• A support George community, kitchen and refreshment team

• Excellent assistance from Government on national, provincial and local level, the community and nongovernmental organisations

• The South African President extends wishes and compliments all rescues for their diligent efforts and achievements.

Lessons learned for improvement

• Imperative requirement: a motion sonar scanner is crucial for accurately determining the location and orientation of patients currently restricted

• Comprehensive volunteer management system – skills and support

• Skills training programmes with the aim of capacity building

We would like to acknowledge and express our gratitude for the efforts, diligence and commitment of the EMS personnel, rescuers, SAPS, Fire and Disaster Management personnel and all volunteers whose support was instrumental in executing the rescue operation.